June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Micropulsed Cyclophotocoagulation in Pediatric Patients with Refractory Glaucoma
Author Affiliations & Notes
  • Isis Fernanda Vazquez
    Instituto de Oftalmologia y Ciencias Visuales, Universidad de Guadalajara, Tonala, Mexico
  • Jose A Paczka
    Instituto de Oftalmologia y Ciencias Visuales, Universidad de Guadalajara, Tonala, Mexico
    Research, Unidad de Diagnostico Temprano de Glaucoma, Guadalajara, Jalisco, Mexico
  • Sara Aurora Garcia y Otero Sánchez
    Instituto de Oftalmologia y Ciencias Visuales, Universidad de Guadalajara, Tonala, Mexico
  • Andrea Orozco Garcia
    Instituto de Oftalmologia y Ciencias Visuales, Universidad de Guadalajara, Tonala, Mexico
  • Footnotes
    Commercial Relationships   Isis Vazquez, None; Jose Paczka, None; Sara Aurora Garcia y Otero Sánchez, None; Andrea Orozco Garcia, None
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5229. doi:
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      Isis Fernanda Vazquez, Jose A Paczka, Sara Aurora Garcia y Otero Sánchez, Andrea Orozco Garcia; Micropulsed Cyclophotocoagulation in Pediatric Patients with Refractory Glaucoma. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5229.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Due to the difficult management of pediatric glaucomas with medical therapy, the primary treatment approach that has to be considered is surgical. A feasible surgical option is the micropulse transscleral cyclophotocoagulation (MP-TSCPC) although very scarce information is present regarding results with this relatively new treatment on pediatric glaucoma patients. The aim of this study is to investigate the short-term efficacy and safety of MP-TSCPC on a consecutive case series of children affected with refractory glaucoma.

Methods : A retrospective review of consecutive case series of patients younger than 17 years of age with refractory glaucoma which underwent MP-TSCPC in a specialized center in Western Mexico. All consecutive cases with complete clinical information during at least 6 months of follow-up were included. A surgical procedure success was defined if the following standard criteria were met: (1) the postoperative IOP remained in a range of 5-21 mm Hg and was reduced at least 30% compared to the baseline IOP with or without medication (complete or qualified success), (2) there was no loss of light perception or vision-threatening severe complications, and (3) no additional glaucoma surgery was required. Minor and major complications as well as their outcomes were also registered.

Results : Fourteen eyes of 10 children (mean age, 9.5 ± 4.9 years; 6 female, 4 male) were included in the study. Mean power and time of MP-TSCPC were 2,500 ± 219.26 mW or 122.96 ± 10.77 J, and 157.14 ± 31.23 seconds, respectively. Preoperatively, the mean intraocular pressure (IOP) was 31.93 ± 6.37 mm Hg. Postoperatively, the mean IOP significantly decreased at all follow-up points: 22.42 ± 6.56 mm Hg at 1 day (P=0.0006), 15.71 ± 6.2 mm Hg at 7 days (P<0.0001), 12.94 ± 7.13 mm Hg at 1 month (P<0.0001), 15.84 ± 5.75 mm Hg at 3 months (P<0.0001), and 17.43 ± 6.21 mm Hg (P<0.0001) at 6 months. No significant complications were noted. The success rate was 85.7% at 6 months. One out of 14 cases required reoperation during the 6 months of follow-up.

Conclusions : The reported clinical efficacy and safety of PC-TSCPC to treat refractory glaucomas in the current case series of children is promising but long-term studies are warranted. Laser energy parameters have to be assessed in order to identify pertinent treatment regimes related to disease severity.

This is a 2020 ARVO Annual Meeting abstract.

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